Pharmacology of Antiseizure Drugs

Question 1

What is the drug of choice for grand mal seizures?

also partial seizures [simple + complex]

Answer 1

Phenytoin

Question 2

What is the mechanism of phenytoin?

Answer 2

Blocks PTP

Alters neuronal calcium permability = decrease glutamate release, enhances GABA release

Question 3

Gingival hyperplasia and Hirsutism along with Sedation, ataxia, diplopia, nystagmus are common side fx of which drug?

Answer 3

Phenytoin

Question 4

what is happening:

1. EOSINOPHILIA
2. system sx (fever, actue rach, lymphadenopathy)
3. lymphocytosis, thrombocytopenia
4. internal organ involvement

Answer 4

DRESS syndrome (Drug reaction with Eosinophilia and System Symptoms)

Question 5

What are 4 drugs that can cause DRESS Syndrome?

Answer 5

Phenobarbital
Carbamazepine
Phenytoin
Lamotrigine

Question 6

What is the best choice of drug for Partial seizures and generalized tonic-clonic seizures?

1. world wide for best balance of safety, efficacy, cost
2. Drug of choice in the US?

Answer 6

1. Carbamazepine

2. Levetiracetam

Question 7

Which drug causes Hyponatremia (SIADH)
Rash in Asians
Agranulocytosis
as Side fx?

Answer 7

Carbamazepine
Oxcarbazepine - less toxic
Eslicarbazepine

Question 8

What is a Second line drug for Absence seizures and focal seizures that
blocks NMDA receptors and elevates GABA?

Answer 8

Valproid Acid

Question 9

What is the primary action of Lamotrigine?

Answer 9

increase recovery time of sodium channel from inactivation and inhibits calcium entry

Question 10

What is effective in treating Lennox Castaut/Infantile Spasms?

Answer 10

Topiramate

Question 11

Which drug is reserved for partial seizures in infants?

Answer 11

Phenobarbital

Question 12

What type of seizure is Clonazepam approved for?

Answer 12

Myoclonus